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[IPp] Exercise can be a challenge for diabetics


Sunday, February 20, 2005 7 Last updated 6:11 p.m. PT

Exercise can be a challenge for diabetics


 ALBANY, N.Y. -- During a game in her junior year, Ithaca College field hockey
player Sarah Gibble knew something wasn't right.

 "I started to feel very out of sorts, almost to the point of getting confused,"
she said. "Nothing was really working for me. I kept fumbling with the ball."

 Gibble, who has type 1 diabetes, left the game and tested her blood sugar level
- well below normal. Some juice and a granola bar got her back on the field.

 She continued to play through her senior year, dealing with the challenges
faced by thousands of athletes with diabetes. While exercise is beneficial for
diabetics, helping to stave off complications and control blood sugar, it takes
planning and care to participate safely.

 Former NBA center Chris Dudley, golfers Scott Verplank and Kelli Kuehne,
Olympic swimmer Gary Hall Jr. and Hockey Hall of Famer Bobby Clarke are among a
long list of accomplished diabetic athletes.

  Around 800,000 people have type 1, or juvenile, diabetes in which the pancreas
produces none of the blood-sugar regulating insulin. Type 1 diabetics need to
take daily injections or use an insulin pump.

 Most of the nation's 18 million diabetics have type 2, or adult-onset diabetes
in which insulin is still present, but isn't used properly by the body. Obesity,
high cholesterol, high blood pressure, physical inactivity and family history
are all risk factors for type 2. Treatments include diet, oral medication and
insulin shots.

 The most common problem for type 1 diabetics is hypoglycemia, or low blood

 During exercise, the body depletes its stores of sugar, then cuts insulin
production to compensate for the lower sugar levels. But in people taking
insulin shots or using a pump, that doesn't happen. Instead, hypoglycemia sets
in, causing symptoms including dizziness, sweating, confusion and nervousness.
Untreated, a person can lose consciousness, become comatose or even die.

 Taking too little insulin can cause problems for an athlete too, said Dr. James
Desemone, director of the Goodman Diabetes Service at Albany Medical Center.
During physical activity, the body releases hormones like adrenaline that
counteract insulin. That increases bloodstream levels of glucose and ketones,
byproducts formed when fat is burned for energy, which can be dangerous.

 Diagnosed with type 1 diabetes 30 years ago, Desemone works with many athletes
with diabetes, from hockey players to cyclists.

 The key, he says, is setting up a regimen using insulin injections or a pump to
mimic the functioning of a normal pancreas during exercise, adjusting how much
insulin is given to the body and when. Drinking enough liquids is also important
to maintain correct blood sugar levels, he said.

 Paula Harper, 61, started the Diabetes Exercise and Sports Association in 1985,
a nonprofit group with about 3,000 members in North America and Europe. A
longtime runner and nurse who has competed in 35 marathons, Harper was
frustrated trying to come up with the right formula to keep her blood sugar
level up over long distances.

 "When I started, it was all trial-and-error," said Harper, a diabetic since
1972. "And trial-and-error can get you in trouble sometimes."

 She recalled races when she ate a Fig Newton every two miles to keep her blood
sugar up, and with the help of her husband, pricked her finger every five miles
to test it.

 A recent National Institutes of Health study showed that 58 percent of people
with pre-diabetes - where blood sugar is elevated but not to the level of type 2
diabetes - staved off type 2 diabetes by exercising moderately 30 minutes a day
and by cutting their weight by 5 to 10 percent.

 "I so firmly believe exercise is important for everybody, but especially for
diabetes," Harper said. Her organization is "trying to help people with type 1
exercise safely and give those with type 2 the motivation to get off the couch."


On the Net:

Diabetes Exercise and Sports Association: http://www.diabetes-exercise.org

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